Inhibin as a marker for granulosa-cell tumors

N Engl J Med. 1989 Sep 21;321(12):790-3. doi: 10.1056/NEJM198909213211204.


Inhibin is a peptide hormone normally produced by ovarian granulosa cells. It reaches a peak of 772 +/- 38 U per liter in the follicular phase of the menstrual cycle and is undetectable in the serum of menopausal women. To determine whether measurements of serum inhibin levels would provide a biochemical marker of the presence or progression of ovarian granulosa-cell tumors and their metastases, we measured the serum immunoreactive inhibin concentrations in six women with such tumors. Three women had been treated by hysterectomy and bilateral salpingo-oophorectomy. In the two women with residual or recurrent disease, the serum inhibin levels were abnormally elevated 5 and 20 months before the clinical manifestations of recurrence became evident. The maximal concentrations approached 3000 U per liter. The serum inhibin level remained undetectable in one patient who was disease-free for 11 years. Serum inhibin concentrations were also elevated in three women with amenorrhea and infertility that resulted from small granulosa-cell tumors. After the removal of the tumors, the serum inhibin levels in these women became normal, and fertility returned. There was a significant negative correlation between the serum concentrations of inhibin and follicle-stimulating hormone, in a manner consistent with the autonomous production of inhibin by granulosa-cell tumors. We conclude that granulosa-cell tumors produce inhibin. Since serum inhibin levels reflect the size of the tumor, measurements of inhibin can be used as a marker for primary as well as recurrent disease.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amenorrhea / blood
  • Amenorrhea / etiology
  • Biomarkers / blood*
  • Female
  • Granulosa Cell Tumor / blood
  • Granulosa Cell Tumor / complications
  • Granulosa Cell Tumor / diagnosis*
  • Humans
  • Infertility, Female / blood
  • Infertility, Female / etiology
  • Inhibins / blood*
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / diagnosis*


  • Biomarkers
  • Inhibins